Provider Demographics
NPI:1275796443
Name:ANCHOR MEDICAL CENTER
Entity Type:Organization
Organization Name:ANCHOR MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-229-3990
Mailing Address - Street 1:12781 SW 42ND ST
Mailing Address - Street 2:STE H
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3437
Mailing Address - Country:US
Mailing Address - Phone:305-229-3990
Mailing Address - Fax:305-229-3880
Practice Address - Street 1:12781 SW 42ND ST
Practice Address - Street 2:STE H
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3437
Practice Address - Country:US
Practice Address - Phone:305-229-3990
Practice Address - Fax:305-229-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty